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CITY OF ORONO PERMIT NO.: 200�-003�� <br /> � 2750 KELLEY PARKWAY <br /> '} ORONO, MN 55356- �ATE IssuEn: 10/22/2008 <br /> 952 249-4600 FAX: 952 249-4616 <br /> ADDRESS : 3585 FREDERICK ST <br /> PIN : 20-117-23-12-0025 <br /> LEGAL DESC : T[LLSONS VILLA CARMAN <br /> : LOT 005 BLOCK 001 <br /> PERMIT TYPE : MECHANICAL(>$500) <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : MECHANICAL-MULTIPLE <br /> VALUATION : $ 1,200.00 <br /> NOTE: 1 MODINE UNIT HEATER-GAS <br /> SIDEWALL VENT FOR HEATER <br /> INSTALL NEW GAS LINE <br /> APPLICANT MECHANICAL 35.00 <br /> KLEVE HEATING&AIR STATE SURCHARGE MECH(VALUATION) 0.60 <br /> 6365 CARLSON DRIVE SUITE G TOTAL 35.60 <br /> EDEN PRAIRIE, MN 55346- <br /> (612)941-421 1 <br /> OWNER <br /> VRCHOTA&MITCHELL KUSY, SCOTT <br /> 3585 FREDERICK ST <br /> WAYZATA, MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only[he work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances governing this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of 180 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the State Building Code.This permit may be <br /> revoked at any time for due cause. <br /> Y�"� � / / / / <br /> Applicant Permitee Signature Date Issued By ' nature - Date <br /> SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBE BOVE. <br />